Curriculum Overview and Rotations
Our Neurology Residency Program is a four-year categorical program in neurology that includes a preliminary (PGY-1) year of internal medicine training. This preliminary year is supervised by both the neurology and internal medicine program directors. The core curriculum of the first year is identical to that of the First Year Categorical Medicine residents. For more information, see the Neurology Residency Handbook and a sample block schedule.
As a four-year integrated program, the first post-graduate year is included in the residency match program. This year is a traditional categorical medicine training that is split equally between the University of Kansas Hospital under the supervision of the Internal Medicine Residency Program and the Internal Medicine service at the Kansas City, MO Veterans Administration Medical Center.
The major objectives for the first year of training are:
- To develop proficiency in the evaluation and management of hospitalized patients with acute and sub-acute illnesses.
- To become proficient in basic medical procedures.
- To pass USMLE part 3
The first year of neurology is weighted toward teaching the resident patient care responsibilities. The residents learn how to perfect their neurological exam, evaluate patients with neurological problems, develop a plan of evaluation, and to initiate treatment. As the year progresses, residents achieve greater levels of autonomy and take more responsibility in teaching of medical students and residents rotating on the neurology service.
The major objectives for this year of training are:
- To develop proficiency in the neurological interview and examination.
- To use these findings to generate a broad differential diagnosis starting with the most likely diagnosis.
- To understand the appropriate use of clinical and laboratory testing; and their indications, cost, specificity, and sensitivity. They also learn how to prioritize the tests based upon the ordering of their differential diagnosis, the prevalence of disease states and the likelihood ratio of the tests.
- To triage, stabilize and manage patients presenting to the ER with acute neurological disease.
- To learn how to coordinate and supervise a clinical team as well as partner with allied health team members to optimize patient care.
- To conduct appropriate literature searches and understand electronic patient information systems.
- To explain to the patient and family in a clear and respectful manner, information about the patient's disease and prognosis.
- To understand gross and microscopic pathology and correlate it with clinical and neuroimaging information.
The year is spent:
- Ward service - KU Hospital (five months) and KC VAMC (four months)
- Leavenworth VA Medical Center - combined consult and clinic service (one month)
- Neuropathology / Neuroradiology (one month)
- Consults - KU or VA (one month)
This second year of neurology training continues to refine the resident's abilities in patient care and also educates the resident about the specialized skills required of a neurologist.
The main objectives are:
- To further refine the neurological interview and examination and to demonstrate a problem-focused approach.
- To demonstrate a broadening fund of knowledge in neurological disease.
- To develop skill in reading electroencephalograms and evoked potentials.
- To acquire proficiency in reading CT, MRI, and plain film studies.
- To teach and manage a clinical team with medical students and residents from other programs rotating on service.
- To demonstrate knowledge of the principles of evidence-based medicine.
- To learn the basic principles of research under the guidance of a faculty mentor.
- To make informed decisions about diagnostic and therapeutic interventions based on patient preferences, current scientific evidence and clinical judgment.
- To competently perform lumbar punctures and basic electrodiagnostic studies.
- To work effectively as a neurological consultant and be responsive to the patient's referring physician(s).
- To develop and to sustain a therapeutic and ethically sound relationship with patients.
The year is spent:
- Consult service - KU Hospital (two months); Kansas City Veterans Affairs Medical Center (two months)
- Ward Supervision - KU Hospital (one month)
- NICU (one month)
- Leavenworth (one month, combined clinic and consult service with introduction to clinical neurophysiology)
- EMG and EEG (one month each)
- Electives (three months)
The final year of training is weighted towards rounding out the resident's education with continued exposure to the disciplines of pediatric neurology, psychiatry, and elective time, though two to three months are also spent on consult services. Elective time is individualized based on the resident's career plans.
The learning objectives are:
- To demonstrate an increasing ability to function independently as a neurologist.
- To demonstrate an extensive fund of knowledge of common neurological disorders, some familiarity with rare disorders, and the ability to research the differential of a rare disorder based upon his or her own clinical evaluation.
- To provide advanced teaching of neurological disorders and exam techniques and to mentor junior neurology residents.
- To demonstrate sensitivity to pediatric patients and their families, and understand the different needs of the pediatric patient and their parents.
- To demonstrate proficiency in reading EEGs, neuroimaging studies, and performing EMG/NCV studies.
- To complete a research project with faculty guidance and present it in a scholarly fashion.
- To apply the methods of evidence-based medicine to the analysis of medical literature.
- To learn and make best use of different services provided by ancillary members of the pediatric health care team, including developmental specialists, geneticists, and behavioral psychologists.
- To develop their career path through seeking and evaluating job opportunities in fellowships and in practice.
The year is spent:
- Child neurology at Children's Mercy Hospital (three continuous months)
- Consults at KU Hospital (two months)
- Ward supervision at KU Hospital (one month)
- Psychiatry (one month)
- Electives (five months)
- Specialty clinic / service
- MS, movement disorders
- Sleep disorders
- Movement disorders
- Subspecialty clinics (as arranged by the resident)
- Private practice neurology
- Faculty mentor
- Research plan and product
KU Training Summary
- Clinical adult neurology - 21 months (including two months of NICU)
- Child neurology - three months
- Neuropathology/neuroradiology - one month
- Psychiatry - one month
- Neuromuscular and Epilepsy (one month each)
- Elective - eight months
- KUMC Frequency: In August 2014, we started a night float system. Two residents share night float for a month and a senior resident is on a 24-hour call on the weekend.
- KCVAMC home call - every other week
- NICU call is every fourth night
- CMH home call every third night
- ½ Day each week for PGY 2-4
- Faculty supervision changes for each level
- Typical work load
- PGY2: (first six months) 1 new, 2 returns
- PGY3 and 4: 2 new, 3 follow ups
- KU Hospital patients assigned to clinics
- Referrals from KUMC and outside clinicians
- Twice weekly morning report with Dr. Richard Barohn, department chairman, and Dr. Richard Dubinsky, residency program coordinator.
- Journal Club: Monthly Evidence Based Journal club
- Critical appraisal of methodology, inherent limitations and bias of each study, led by Gary Gronseth, M.D., vice chairman of the department, and Richard Dubinsky, M.D., MPH.
- Weekly reading conference with April McVey, M.D.
- Two-year curriculum covering adult neurology using the AAN's Continuum.
- Monthly lectures in neuro-ophthalmology and pediatric neurology
- Weekly case conference and grand rounds
- Third Friday of June
All residents and fellows present a 15-minute platform presentation
- PGY 2 usually case reports
- PGY 3 and 4: hypothesis driven
- Yearly didactics on clinical research by Drs. Gronseth and Dubinsky
- Award for best research for each level
Aug 11, 2014